Faster lab diagnosis, faster action to treat

The testing epicenter at Dameron Hospital is a large, brightly-lit laboratory permeated with the sound of humming machines.

Deborah Schoch

The testing epicenter at Dameron Hospital is a large, brightly-lit laboratory permeated with the sound of humming machines.

One morning in August, technical assistant Mary Poier stations herself under a protective hood, grasps an amber-tinted container with a gloved hand and tilts it to show the watery contents inside. This is a patient's stool sample, and she's about to demonstrate how Dameron conducts its testing for the infection called Clostridium difficile.

She moves a small piece of the sample into a blue capsule and walks over to a 3-foot-high gray box labeled "GenXpert." There, she signs onto a computer and pops the capsule into a computer-assigned drawer in the machine.

In just 48 minutes, the box can detect if the sample tests positive for C. diff. That means the hospital staff can make a diagnosis just two hours after taking a sample, compared to two days or longer with some older tests.

"A faster ID helps get the patient in isolation as soon as possible, so we can prevent the spread and start treatment," said Dameron nurse epidemiologist Linda Knowles.

That's one reason Lodi Memorial Hospital also moved to the newer, more expensive test.

"We were looking to rapidly ID patients upon admission," said Mark Sey, vice president and chief administrative officer at the hospital.

Yet some experts wonder if the sensitivity this type of testing can lead to false positives.

"It's a much more complicated story than just saying it's the best test," said Dr. Stuart H. Cohen, hospital epidemiology director at UC Davis Medical Group and the lead author of the C. difficile guidelines for the Society of Healthcare Epidemiology of America.

And some hospitals may be wary of using this method because their rates of infection may climb, Cohen and others said.

Put another way, hospitals that spend the extra money on this testing might end up looking worse in the hospital quality ratings.

"With C. diff," Cohen said, "There's a sort of finger-pointing that goes along with it - 'Your facility isn't clean, you didn't do this right, you didn't do that right.'"